Taylor-Robinson raises a very important point. While our article1 deliberately focused on National Immunisation Program Schedule vaccines, which are provided free of charge to eligible Australians, there are other adult groups at risk of undervaccination. Vaccines are recommended due to an increased risk of infection or transmission to specific vulnerable groups, most of whom are adults, but the vaccines incur a cost to recipients. As mentioned by Taylor-Robinson, travel vaccines are an important group in this category. We would add the measles-mumps-rubella vaccine to those mentioned, as measles importation by returning travellers has resulted in many local clusters of disease. In fact, the measles-mumps-rubella vaccine is recommended for all adults born after 1966 who have not previously received two doses, whether or not they are about to travel, and in some states it is funded for this purpose. Another large group is occupational vaccines, which includes all health care workers, people who work with or care for children or older people, emergency and essential service workers, laboratory personnel, people who work with human tissue or body fluids, and others as listed in the Australian Immunisation Handbook.2 These groups are generally less actively monitored or promoted than those covered under the National Immunisation Program Schedule, with the possible exception of health care workers in some areas or jurisdictions. This situation further underlines the case for immunisation to be regarded as a whole-of-life endeavour, and to ensure that relevant data are captured by the new Australian Immunisation Register (eg, on travel, migrant and refugee status) and is accessible to primary care providers to check the immunisation status.3 A useful summary of adult immunisation recommendations is provided in the adult immunisation fact sheet produced by the National Centre for Immunisation Research and Surveillance.4
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